Individual
JULIANNA LARAINE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 S 4TH ST, SANTA ROSA, NM 88435-2417
(575) 472-0745
(575) 472-0746
Mailing address
HC 68 BOX 978, SANTA ROSA, NM 88435-9700
(575) 403-5451
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/05/2010
Last updated
08/05/2010
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